In 2008, the U.S. government spent $700 billion on the banking bailout, known as TARP and nearly $600 billion on chronic disease.

Heart disease, asthma, cancer and diabetes are among the many conditions that make up chronic disease in the U.S. Together, chronic conditions impact 45% of the population; more than 133 million Americans has at least one chronic condition.

According to the Milken Institute, by 2023, the U.S. will experience a more than 50% growth in cancer, mental disorders, and diabetes, and over 40% increase in cases of heart disease.

What’s also going to drive up health spending in America is “metabolic syndrome” — that is the quartet of diabetes, high blood pressure, high cholesterol, and obesity – especially fast-growing in the youngest American cohort.

The 2009 Almanac of Chronic Disease slices and dices data on the topic in a broad range of ways. This is required reading for anyone interested in understanding the most difficult challenge facing the U.S. health economy, employer profitability and employee productivity, and the long-term fiscal stability of the nation.

Health Populi’s Hot Points: 75 cents of every dollar spent on health in the U.S. goes to treating people with chronic diseases. This is where health reform spending must focus to make a sustainable impact on the long-term fiscal health of the nation: addressing chronic care.

To do that will require a total realignment of resources and incentives that encourage prevention and wellness, address chronic care management recognizing that many people with chronic disease have to manage more than one condition, and understanding the central role that patients/people/health citizens must play in participatory health — that is, engaging individuals to care for themselves the best way they can. This will require attention on behavioral incentives and economics. Without putting the person at the center of this effort, chronic care won’t be effectively managed. It’s self-care that’s going to make the nation able to stem the growth of chronic care costs.

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